ATMOFIZER Order Form

ORDER FORM: Atmofizer One

One Unit, charge cord w/US plug • Covers ~650 sq ft (Approx. 25'x25' room) • Usually Ships within 7-10 days
Your Name *

First Name Last Name
Business Name
ABC Co.
Shipping Address *

Street Address

Street Address Line 2

City State

Zip Code
Email *
john@company.com
Phone Number *

Area Code Phone Number
Which USA Rapid Test Partner Referred You? *
ie. Joe, or ABC Co., or None

How Many ATMOFIZER One Units? *

1 - 9 Atmofizer One Units $ 995.00

One (1) unit per order.

Quantity
Item subtotal: $ 0.00

10-25 Atmofizer One Units $ 895.00

One (1) unit per order.

Quantity
Item subtotal: $ 0.00

Enter coupon

Subtotal $ 0.00 Shipping $ 0.00 Total $ 0.00

ORDER FORM: Atmofizer One